1. (a) License application forms. License application forms may be obtained from the department, 1100 West 49th Street, Austin, Texas, 78756, or online at http://www.dshs.state.tx.us/license.shtm.

2. (b) Contents of license application. The application for licensure as a wholesale distributor of prescription drugs shall be signed and verified, submitted on a license application form furnished by the department, and contain the following information:

   1. (1) all trade or business names under which the business is conducted;
   2. (2) the address and telephone number of each place of business that is licensed;

   3. (3) the type of business and the name, residence address, and valid driver's license number of:

      1. (A) the proprietor, if the business is a proprietorship;
      2. (B) all partners, if the business is a partnership; or
      3. (C) all principals, if the business is an association;
   4. (4) the date and place of incorporation, if the business is a corporation;

   5. (5) the names and business addresses of the individuals in an administrative capacity showing:

      1. (A) the managing proprietor, if the business is a proprietorship;
      2. (B) the managing partner, if the business is a partnership;
      3. (C) the officers and directors, if the business is a corporation; or
      4. (D) the persons in a managerial capacity, if the business is an association;
   6. (6) the name, date of birth, residence address, telephone number, and any information necessary to complete a criminal history record check on a designated representative of each place of business;
   7. (7) the state of incorporation, if the business is a corporation;
   8. (8) a list of all licenses and permits issued to the applicant by any other state under which the applicant is permitted to purchase or possess prescription drugs;
   9. (9) the name of the manager for each place of business;
   10. (10) a list of categories which must be marked and adhered to in the determination and paying of the fee; and
   11. (11) a statement verified by the applicant's signature that acknowledges the applicant has read, understood, and agrees to abide by the provisions of these sections and those of the Texas Food, Drug, and Cosmetic Act, Health and Safety Code, Chapter 431.

3. (c) Designated representatives and managers.

   1. (1) For each person who is a designated representative and/or a manager of each place of business, the applicant shall provide the following to the department:

      1. (A) the person's place(s) of residence for the past seven years;
      2. (B) the person's date and place of birth;
      3. (C) the person's occupations, positions of employment, and offices held during the past seven years;
      4. (D) the business name and address of any business, corporation, or other organization in which the person held an office under subsection (b)(3) of this section or in which the person conducted an occupation or held a position of employment;
      5. (E) a statement of whether during the preceding seven years the person was the subject of a proceeding to revoke a license and the nature and disposition of the proceeding;
      6. (F) a statement of whether during the preceding seven years the person has been enjoined, either temporarily or permanently, by a court from violating any federal or state law regulating the possession, control, or distribution of prescription drugs, including the details concerning the event;
      7. (G) a written description of any involvement by the person with any business, including any investments, other than the ownership of stock in a publicly traded company or mutual fund during the past seven years, that manufactured, administered, prescribed, distributed, or stored pharmaceutical products and any lawsuits in which the businesses were named as a party;
      8. (H) a description of any felony offense for which the person, as an adult, was found guilty, regardless of whether adjudication of guilt was withheld or whether the person pled guilty or nolo contendere;
      9. (I) a description of any criminal conviction of the person under appeal, a copy of the notice of appeal for that criminal offense, and a copy of the final written order of an appeal not later than the 15th day after the date of the appeal's disposition; and
      10. (J) a photograph of the person taken not earlier than 30 days before the date the application was submitted.
   2. (2) The information submitted under paragraph (1) of this subsection must be attested to under oath.
4. (d) Criminal history. The department will obtain an applicant's criminal history record information and may forward the fingerprints to the Federal Bureau of Investigation for a federal criminal history check.
5. (e) Renewal license application. The renewal application for licensure as a wholesale distributor of prescription drugs shall be made on a license application form furnished by the department.
6. (f) Texas Online. Applicants may submit initial and renewal license applications under these sections electronically by the Internet through Texas Online at www.texasonline.state.tx.us. The department is authorized to collect fees, in amounts determined by the Texas Online Authority, to recover costs associated with application and renewal application processing through Texas Online.

Source Note:The provisions of this §229.425 adopted to be effective February 1, 2007, 32 TexReg 315.